Structured Chart Review: Assessment of a Structured Chart Review Methodology.

Humans Medical Audit Medical Records Morbidity Mortality Reproducibility of Results Surveys and Questionnaires

Journal

Hospital pediatrics
ISSN: 2154-1671
Titre abrégé: Hosp Pediatr
Pays: United States
ID NLM: 101585349

Informations de publication

Date de publication:
01 2020
Historique:
pubmed: 28 12 2019
medline: 31 7 2021
entrez: 28 12 2019
Statut: ppublish

Résumé

Chart reviews are frequently used for research, care assessments, and quality improvement activities despite an absence of data on reliability and validity. We aim to describe a structured chart review methodology and to establish its validity and reliability. A generalizable structured chart review methodology was designed to evaluate causes of morbidity or mortality and to identify potential therapeutic advances. The review process consisted of a 2-tiered approach with a primary review completed by a site physician and a short secondary review completed by a central physician. A total of 327 randomly selected cases of known mortality or new morbidities were reviewed. Validity was assessed by using postreview surveys with a Likert scale. Reliability was assessed by percent agreement and interrater reliability. The primary reviewers agreed or strongly agreed in 94.9% of reviews that the information to form a conclusion about pathophysiological processes and therapeutic advances could be adequately found. They agreed or strongly agreed in 93.2% of the reviews that conclusions were easy to make, and confidence in the process was 94.2%. Secondary reviewers made modifications to 36.6% of cases. Duplicate reviews ( A structured chart review by knowledgeable primary reviewers, followed by a brief secondary review, can be valid and reliable.

Sections du résumé

BACKGROUND AND OBJECTIVES
Chart reviews are frequently used for research, care assessments, and quality improvement activities despite an absence of data on reliability and validity. We aim to describe a structured chart review methodology and to establish its validity and reliability.
METHODS
A generalizable structured chart review methodology was designed to evaluate causes of morbidity or mortality and to identify potential therapeutic advances. The review process consisted of a 2-tiered approach with a primary review completed by a site physician and a short secondary review completed by a central physician. A total of 327 randomly selected cases of known mortality or new morbidities were reviewed. Validity was assessed by using postreview surveys with a Likert scale. Reliability was assessed by percent agreement and interrater reliability.
RESULTS
The primary reviewers agreed or strongly agreed in 94.9% of reviews that the information to form a conclusion about pathophysiological processes and therapeutic advances could be adequately found. They agreed or strongly agreed in 93.2% of the reviews that conclusions were easy to make, and confidence in the process was 94.2%. Secondary reviewers made modifications to 36.6% of cases. Duplicate reviews (
CONCLUSIONS
A structured chart review by knowledgeable primary reviewers, followed by a brief secondary review, can be valid and reliable.

Identifiants

DOI: 10.1542/hpeds.2019-0225 PMID: 31879317 PMC: PMC6931034
pubmed: 31879317
pii: hpeds.2019-0225
doi: 10.1542/hpeds.2019-0225
pmc: PMC6931034
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

61-69

Subventions

Organisme : NICHD NIH HHS
ID : P2C HD047879
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD083166
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD049981
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD083170
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD049934
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD050096
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD063114
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD050096
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD050012
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD083171
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD049983
Pays : United States
Organisme : NICHD NIH HHS
ID : RL1 HD107773
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD063108
Pays : United States

Informations de copyright

Copyright © 2020 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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Auteurs

Ashley Siems (A)

School of Medicine and Health Sciences, The George Washington University and Children's National Health System, Washington, District of Columbia.

Russell Banks (R)

School of Medicine, University of Utah, Salt Lake City, Utah.

Richard Holubkov (R)

School of Medicine, University of Utah, Salt Lake City, Utah.

Kathleen L Meert (KL)

Wayne State University and Children's Hospital of Michigan, Detroit, Michigan.

Christian Bauerfeld (C)

Wayne State University and Children's Hospital of Michigan, Detroit, Michigan.

David Beyda (D)

College of Medicine-Phoenix, University of Arizona and Phoenix Children's Hospital, Phoenix, Arizona.

Robert A Berg (RA)

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Yonca Bulut (Y)

University of California, Los Angeles and University of California, Los Angeles Mattel Children's Hospital, California.

Randall S Burd (RS)

School of Medicine and Health Sciences, The George Washington University and Children's National Health System, Washington, District of Columbia.

Joseph Carcillo (J)

University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.

J Michael Dean (JM)

School of Medicine, University of Utah, Salt Lake City, Utah.

Eleanor Gradidge (E)

College of Medicine-Phoenix, University of Arizona and Phoenix Children's Hospital, Phoenix, Arizona.

Mark W Hall (MW)

Nationwide Children's Hospital, Columbus, Ohio.

Patrick S McQuillen (PS)

University of California, San Francisco and University of California, San Francisco Benioff Children's Hospital, San Francisco, California.

Peter M Mourani (PM)

University of Colorado and Children's Hospital of Colorado, Denver, Colorado.

Christopher J L Newth (CJL)

Keck School of Medicine, University of Southern California and Children's Hospital Los Angeles, Los Angeles, California; and.

Daniel A Notterman (DA)

Princeton University, Princeton, New Jersey.

Margaret A Priestley (MA)

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Anil Sapru (A)

University of California, Los Angeles and University of California, Los Angeles Mattel Children's Hospital, California.

David L Wessel (DL)

School of Medicine and Health Sciences, The George Washington University and Children's National Health System, Washington, District of Columbia.

Andrew R Yates (AR)

Nationwide Children's Hospital, Columbus, Ohio.

Athena F Zuppa (AF)

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Murray M Pollack (MM)

School of Medicine and Health Sciences, The George Washington University and Children's National Health System, Washington, District of Columbia; mpollack@childrensnational.org.

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